• 한국사회정책
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• 제25권1호
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Journal of the Korea Convergence Society
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• 제11권3호
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• pp.237-244
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• 2020

Confronting rapid population ageing, Japanese government proposes various types of regional comprehensive care programs for elderly people. In particular, the Japanese government and local governments are making efforts to ensuring long-term care workforce. Among others, the government is pursuing measures to secure specialized manpower in various ways 1) Construction of infrastructure, 2) Loan system for long-term care worker, 3) Inflow of long-term care staff for foreign students, etc. Also, universities have trained numerous community care specialists through research centers for health care, social welfare, and specialized education. Korea is also expected to explode the demand for long-term care worker at the rapid rate of aging, and it is necessary to actively discuss measures to cope with it.

• 한국사회정책
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• 제25권1호
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• pp.125-159
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• 2018

The purpose of this study is to analyze the factors affecting service use intention of long-term care among the disabled. This study conducts a longitudinal study using the modified Andersen model by the disabled age groups of the 50-64 group and the 65 over group. This study examined random effects panel logit analysis for the 50-64 group and the 65 over group by age variations. The results have shown that there are different factors Influencing factors for each specific age group of the disabled(50-64, 65 over). The results were as follows: there are differences of factors between the 50-64 group and the 65 over group. This study found that predisposing factors of the service use intention of long-term care were significantly related to age, residential area, education status, existence of spouses. Enabling factors of the service use intention of long-term care were significantly related to long-term care service recognition, saving, personal salary income level, housing status. Need factors of the service use intention of long-term care were significantly related to chronic diseases, psychological health, IADL. So, there are a need for a policy considerations such as service for the mid-old age disabled by age groups. Finally, implications and future research directions were discussed based on the finding of the study.

• Korean Journal of Occupational Health Nursing
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• 제21권3호
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• pp.308-316
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• 2012

Purpose: The purpose of this study was to describe the perception and practice of hospital infection control of nursing staff in long-term care hospitals by the level of supplementation of nurses. Methods: The participants were 212 nurses and nurse assistants in 13 long-term care hospitals in a metropolitan city and the data were gathered by self-reported questionnaires during August 2011 and analyzed by SPSS/WIN program. Results: The beds per a nurse were 15, and the proportion of nurses among nursing staff in long-term care hospitals was about 33%. In general, the level of infection control in practice was lower than that of perception. The highest perception and practice domain was 'Management of disinfection/contamination', and the lower level domains were 'Personal hygiene' and 'Hand washing' There were statistically significant differences in the hospital infection control of perception and practice depending on age, education, career in long-term care hospital, job position, the quantity of beds, nurse, and nurse assistant, beds per a nurse and proportion of nurses in hospitals. Conclusion: According to these results, the systematic and continual education on hospital infection control of the nursing staff in long-term hospitals should be carried out. In addition, the policy to add more nurses into long-term care hospitals must be implemented.

• Journal of Korean Academy of Nursing Administration
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• 제4권2호
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• 한국사회정책
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• 제25권3호
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• pp.103-130
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• 2018

The study aims to analyse Korean Long-Term Care Insurance system in terms of caring justice on the premise that elder care should be included in discussions and policies of care. Caring justice means an ideal of equal sharing duties and rights of care by all citizens. Four dimensions of caring justice(decommodification, defamilialization, degenderization and elderly participation and power) were established for the analysis. The results of the analysis were presented that Korean Long-Term Care Insurance system was maintained by commodificated and gendered care services attempting defamilialization with the exclusion of elderly beneficiaries, which represented typical caring injustice. Policy suggestions were made to realize caring justice: improving the status of caring labour by achieving proper service price and public employment, reorganization of life cycle based caring system integrating children, disabled adults and elders, and developing user-centered long-term care system to guarantee participation and choice of people in caring relationships.

• Health Policy and Management
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• 제27권1호
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• pp.56-62
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• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• The Korean Journal of Rehabilitation Nursing
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• 제12권2호
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• pp.92-101
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• 2009

Purpose: This study was conducted to explore the functional status and long-term care services for the community-dwelling low-income elderly. Method: A descriptive research design was used in this study. The functional status of the participants was obtained using Minimum Data Set-Home Care Version 2.0 and the long-term care services were identified via Michigan's choice. Total of 154 persons aged 65 years or older completed Korean Minimum Data Set-Home Care Version 2.0 on the community dwelling low-income elderly. Results: The average of Activities of Daily Living was 4.19, and the range was 0-55, while the average of Instrument of Activities of Daily Living was 4.85 and the range was 0-56. Among the subjects, 46.1% belonged to the Information and Referral group and 1.3% to the Nursing Home group. Severe daily pain was reported by 14.9%, and 76.6% of the participants had impaired vision. The Activities of Daily Living was difference according to living with, education, vision, and depression. The long-term care services differed according to gender, pain, vision, hearing, and depression. Conclusion: The support policy for the elderly needed to focus on impaired visual and depression to enhance the activities of daily living. Moreover, there is a need for the Information and Referral group to arrange and develop nursing intervention resources.

• Physical Therapy Korea
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• 제29권2호
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• pp.94-105
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• 2022

Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.

• Journal of Digital Convergence
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• 제9권5호
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• pp.45-54
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• 2011

The purpose of this research was to examine the whether to recognition of the long-term care insurance have affected on aged parent-supporting. The research method was used self-report questionnaire to 331 persons who was supported their parents. And I used the Frequency, simple linear regression as an analysis methods. The result demonstrated that Educational background, the emotional intimacy of the subjects, and the recognition degree of the long-term care service have significant influence on their physically parent supporting consciousness. The researchers suggest the need of family support system based on the result for decrease the parent-supporting burden in middle age generation.